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Allergies Health Center

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Living With a Nut Allergy

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With a peanut or tree nut allergy, even a tiny amount ingested or inhaled could cause an allergic reaction. Some of the places you find nuts, like nut butters and nut breads, are not surprising. Others -- like sauces and gravies -- may be.

Once you know what to look for, you can check labels carefully before you buy or use a product.

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Nuts You May Need to Avoid

If you are allergic to peanuts, you may need to avoid tree nuts like walnuts and almonds. Same goes if you’re allergic to tree nuts -- you may need to avoid peanuts. Ask your doctor to be sure. Tree nuts include:

  • Almonds
  • Brazil nuts
  • Cashews
  • Chestnuts
  • Filberts
  • Hazelnuts
  • Hickory nuts
  • Macadamia nuts
  • Pecans
  • Pine nuts
  • Pistachios
  • Walnuts

Common Foods With Nuts

Don't be surprised to find peanuts or tree nuts in foods like these:

  • Baked goods. Cookies, candy, pastries, pie crusts, and others
  • Candy.Chocolate candy especially; also nougat and marzipan
  • Other sweets. Ice cream, frozen desserts, puddings, and hot chocolate
  • Cereals and granola
  • Chex mix
  • Chili and soups. Peanuts or peanut butter are sometimes used as thickeners.
  • Grain breads
  • High-energy bars
  • Honey
  • International foods. Nuts are common in African and Asian cooking (especially Thai and Indian); also in Mexican and Mediterranean foods.
  • Mortadella. This Italian ham may include pistachios.
  • Meat-free burgers
  • Sauces. May include hot sauce, pesto, gravy, mole sauce, glazes, or marinades
  • Salads and salad dressing


Common Ingredients With Nuts

Avoid these when cooking and look for them on prepared food labels:

  • Nut butters. Almond, cashew, peanut, and others
  • Nut pastes. Includes products like marzipan, almond paste, and nougat
  • Nut oils. Includes cold-pressed or expressed peanut oil, and others
  • Hydrolyzed plant or vegetable protein. These can have peanuts in them.
  • Peanut flour
  • Nut extracts, like almond extract


4 Tips for Avoiding Nuts

  • Beware of cross-contact. Foods that don't contain peanuts or tree nuts can get contaminated if they are prepared in the same place or using the same equipment.  Cross-contamination also occurs in ice cream parlors because of shared scoopers and other equipment, as well as in many ethnic restaurants where a wide variety of ingredients are used.
  • Check the label each time you buy a product. Manufacturers sometimes change recipes, and a trigger food may be added to the new one.
  • Look for peanuts outside the kitchen. In addition to foods, nuts can be in lotions, shampoos, and pet food. Check labels before you buy or use them.
  • Carry an epinephrine autoinjector. Carry two with you at all times and know how to inject it. For some people, an allergic reaction to nuts can quickly become life-threatening, so always be prepared. Brands includeEpiPen, Emerade, Twinject, Adrenaclick, Anapen, Jext, Allerject, and Auvi-Q.



WebMD Medical Reference

Reviewed by Stanley M. Fineman, MD, MBA on October 23, 2014
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